Predictive Factors in Sacral Neuromodulation: A Systematic Review

R. Jairam*, J. Drossaerts, T. Marcelissen, G. van Koeveringe, D. Vrijens, P. van Kerrebroeck

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Introduction: Sacral neuromodulation (SNM) is an effective treatment in patients with overactive bladder syndrome or nonobstructive urinary retention when conservative treatment fails. Several factors that could impact outcome with SNM have been studied. This systematic review investigated these predictive factors and their relevance for clinical practice. Methods: Systematic review according to the PRISMA guidelines was conducted. This review is registered in the PROSPERO register (CRD42015016256). Results: Seventy-eight studies (of which 11 abstracts) were included. Females, younger patients, and a tined lead procedure tend to be predictive in successful SNM outcome. Factors that did not influence SNM outcome were prior back surgery, surgery for stress urinary incontinence, affective symptoms, and duration of complaints. Reduced detrusor contractility is associated with a lower success rate. The level of evidence of most studies (graded according to the Centre for Evidence-Based Medicine) was 3b. Conclusion: Even though this systematic review investigated predictive factors (gender, age, type of procedure, type of lead, and detrusor contractility), no general consensus on predictive factors could be made. Most studies are small, retrospective, and involve a heterogeneous population. Therefore, prospective research in larger specific patient groups remains necessary to find predictors of SNM outcome.
Original languageEnglish
Pages (from-to)323-343
Number of pages21
JournalUrologia Internationalis
Volume106
Issue number4
Early online date31 May 2021
DOIs
Publication statusPublished - 2022

Keywords

  • Predictive factors
  • Sacral neuromodulation
  • Overactive bladder
  • Nonobstructive urinary retention
  • Lower urinary tract symptoms
  • NONOBSTRUCTIVE URINARY RETENTION
  • QUALITY-OF-LIFE
  • NERVE-STIMULATION
  • VOIDING DYSFUNCTION
  • OVERACTIVE BLADDER
  • URGE INCONTINENCE
  • URODYNAMIC EVALUATION
  • URETHRAL SPHINCTER
  • PATIENT SELECTION
  • TRACT DYSFUNCTION

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